In the context of caring for a patient diagnosed with Crohn’s disease, which nursing assessment should be prioritized?

Altered mucus membranes

Fluid volume deficit

Nutrition

Skin integrity .

Answer and Explanation

The Correct Answer is C

Choice A rationale

While altered mucus membranes can occur in patients with Crohn’s disease, it is not typically the primary nursing assessment.

Choice B rationale

Fluid volume deficit can occur in patients with Crohn’s disease due to diarrhea, a common symptom of the disease. However, it is not typically the primary nursing assessment.

Choice C rationale

Nutrition should be prioritized in the nursing assessment for a patient diagnosed with Crohn’s disease. Malnutrition can occur due to decreased appetite, malabsorption of nutrients, and increased nutritional needs due to inflammation.

Choice D rationale

While skin integrity can be a concern in patients with Crohn’s disease, particularly those with fistulas, it is not typically the primary nursing assessment.

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Correct Answer is A

Explanation

Choice A rationale

The rubella vaccine is a live vaccine, which means it contains a weakened version of the virus. Because the virus is still active, live vaccines are not safe for pregnant people. There is a small chance they may pass the virus to the baby. Therefore, it is recommended that adults of childbearing age should avoid getting pregnant for at least four weeks after receiving the MMR vaccine. This is to ensure the safety of both the mother and the baby.

Choice B rationale

This statement is incorrect. The rubella vaccine does not require additional shots after each baby with Rh-positive blood. The rubella vaccine is typically administered in childhood and provides long-term protection.

Choice C rationale

This statement is also incorrect. The rubella vaccine does not require additional shots in 1 month and again in 6 months. The vaccine provides long-term protection and does not typically require frequent boosters.

Choice D rationale

While it’s true that some vaccines can cause side effects such as fever and vomiting, these are not common side effects of the rubella vaccine. Therefore, this statement is not entirely accurate.

A. 2 cm above the umbilicus. B. One fingerbreadth above the symphysis pubis. C. At the level of the umbilicus. D. To the right of the umbilicus.

Correct Answer is A

Explanation

Choice A rationale

At about 12 hours after delivery, the uterine fundus can be palpated at 1 cm above the umbilicus. This is the correct answer.

Choice B rationale

One fingerbreadth above the symphysis pubis is not where the uterine fundus is expected to be found 12 hours after a vaginal delivery.

Choice C rationale

At the level of the umbilicus is not where the uterine fundus is expected to be found 12 hours after a vaginal delivery.

Choice D rationale

To the right of the umbilicus is not where the uterine fundus is expected to be found 12 hours after a vaginal delivery.

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In the context of caring for a patient diagnosed with Crohn’s disease, which nursing assessment should be prioritized?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client’s prenatal laboratory findings reveal no immunity to rubella.The health care provider orders the rubella vaccine.The nurse concludes that teaching about this medication is effective when the client states which of the following?

Correct Answer is A

Explanation

A nurse is caring for a patient who had a vaginal delivery 12 hours ago.Where should the nurse expect to find the uterine fundus when palpating the patient’s abdomen?

Correct Answer is A

Explanation

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